Postpartum kidney crisis: hidden burden of postpartum acute kidney injury

Ritu Parashar; Amruta Choudhary; Shalini Dange; Anita Yadav; Anusha Kamath

doi:10.18203/2320-1770.ijrcog20252746

Authors

Ritu Parashar Department of Obstetrics and Gynaecology, AIIMS, Nagpur, Maharashtra, India
Amruta Choudhary Department of Obstetrics and Gynaecology, AIIMS, Nagpur, Maharashtra, India
Shalini Dange Department of Obstetrics and Gynaecology, AIIMS, Nagpur, Maharashtra, India
Anita Yadav Department of Obstetrics and Gynaecology, AIIMS, Nagpur, Maharashtra, India
Anusha Kamath Department of Obstetrics and Gynaecology, AIIMS, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20252746

Keywords:

Acute kidney injury, HELLP syndrome, Preeclampsia, ICU, Multidisciplinary management

Abstract

Postpartum acute kidney injury (PPAKI) is a serious complication of pregnancy. This case series analyses seven patients aged 25-35 years, predominantly with hypertensive disorders such as preeclampsia, HELLP syndrome and eclampsia, with few complicated by sepsis and hemorrhagic shock. Dialysis was necessary in the majority of cases, with one mortality. The severity and multifactorial etiology of PPAKI are highlighted by diagnostic and treatment challenges. Results were greatly impacted by prompt intensive care unit treatment, renal support, and a multidisciplinary approach. In order to prevent irreversible renal damage, this series emphasizes the importance of early detection, aggressive management, and customized postpartum surveillance in high-risk obstetric populations.

Metrics

Metrics Loading ...

References

Taber-Hight E, Shah S. Acute Kidney Injury in Pregnancy. Adv Chronic Kidney Dis. 2020;27(6):455-60. DOI: https://doi.org/10.1053/j.ackd.2020.06.002

Eswarappa M, Madhyastha PR, Puri S, Varma V, Bhandari A, Chennabassappa G. Postpartum acute kidney injury: a review of 99 cases. Ren Fail. 2016;38(6):889-93. DOI: https://doi.org/10.3109/0886022X.2016.1164015

Nwoko R, Plecas D, Garovic VD. Acute kidney injury in the pregnant patient. Clin Nephrol. 2012;78(6):478-86. DOI: https://doi.org/10.5414/CN107323

Mehrabadi A, Liu S, Bartholomew S, Hutcheon JA, Magee LA, Kramer MS, et al. Canadian Perinatal Surveillance System Public Health Agency of Canada. Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study. BMJ. 2014;349:g4731. DOI: https://doi.org/10.1136/bmj.g4731

Kountouris E, Clark K, Kay P, Roberts N, Bramham K, Kametas NA. Postnatal assessment for renal dysfunction in women with hypertensive disorders of pregnancy. J Nephrol. 2021;22:341. DOI: https://doi.org/10.1007/s40620-021-01134-7

Shu H, Nie F. Clinical characteristics and prognosis of postpartum acute kidney injury. J Int Med Res. 2021;49(2):0300060520988388. DOI: https://doi.org/10.1177/0300060520988388